| NPI | 1467604736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENICE TIGGS Executive Director 810-655-3407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AS250272749) |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2008-10-17 |